Evidence map›Paper›PMID 33409787›Full record

ArticleEuropean radiology2021

Comparison of the current guidelines for diagnosing hepatocellular carcinoma using gadoxetic acid-enhanced magnetic resonance imaging.

Shin Hye Hwang, Mi-Suk Park, Sumi Park, Joon Seok Lim, Seung Up Kim, Young Nyun Park

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In one paragraph

Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  8. Current State of Evidence for Use of MRI in LI-RADS.Journal of magnetic resonance imaging : JMRI · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Shin Hye HwangDepartment of Radiology, National Health Insurance Service Ilsan Hospital, Goyang, South Korea.
Mi-Suk ParkDepartment of Medicine, Yonsei University College of Medicine, Seoul, South Korea. radpms@yuhs.ac.ORCID http://orcid.org/0000-0001-5817-2444
Sumi ParkDepartment of Radiology, National Health Insurance Service Ilsan Hospital, Goyang, South Korea.
Joon Seok LimDepartment of Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Seung Up KimDepartment of Internal Medicine, Severance Hospital, Seoul, South Korea.
Young Nyun ParkDepartment of Pathology, Severance Hospital, Seoul, South Korea.

Funding

National Health Insurance Service Ilsan Hospital NHIMC 2018CR091
6 · The paper itself

Abstract

objectivesTo compare the performance of current guidelines applicable to the diagnosis of hepatocellular carcinomas (HCCs) using gadoxetic acid-enhanced magnetic resonance imaging (MRI).

methodsTwo hundred and forty-one hepatic lesions (149 HCCs, six other malignancies, 86 benign lesions) in 177 patients at risk of HCC without a history of previous treatment for hepatic malignancy in a tertiary center were retrospectively reviewed. Either histopathology results or long-term (> 24 months) follow-up images were used as a standard of reference. All lesions were categorized according to the Liver Imaging Reporting and Data System (LI-RADS), European Association for the Study of the Liver (EASL), Asian Pacific Association for the Study of the Liver (APASL), and Korean Liver Cancer Study Group-National Cancer Center (KLCSG-NCC) guidelines. The sensitivity and specificity thereof were assessed using a generalized estimation equation.

resultsFor gadoxetic acid-enhanced MRI, LI-RADS (95%, 95% confidence interval [CI] 88-98) and EASL (94%, 95% CI 86-97) yielded the highest specificity, while EASL yielded the lowest sensitivity (54% [95% CI 46-62]). APASL yielded the highest sensitivity (91% [95% CI 86-95]) with the lowest specificity (78% [95% CI 69-86]). KLCSG-NCC showed balanced sensitivity (85% [79-90]) and specificity (88% [95% CI 80-93]). Differences were more prominent in small nodules between 1 and 2 cm.

conclusionThe diagnostic performance of current guidelines for HCC on gadoxetic acid-enhanced MRI was significantly different, and a potential inverse association between sensitivity and specificity was observed. KEY POINTS: • EASL and LI-RADS yielded the highest specificity with the lowest sensitivity, whereas APASL yielded the highest sensitivity with the lowest specificity. • Differences in the diagnostic performances of guidelines were prominent in small nodules between 1 and 2 cm. • Additional evaluation of CT findings improved the diagnostic sensitivity and accuracy of EASL and LI-RADS. Although doing so decreased specificity, it remained above 89-90%.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsContrast MediaGadolinium DTPAHumansMagnetic Resonance ImagingRetrospective StudiesSensitivity and SpecificityContrast MediaGadolinium DTPAgadolinium ethoxybenzyl DTPACarcinoma, hepatocellularDiagnosisGadolinium DTPAGuidelineMagnetic resonance imaging

Identifiers

PMID33409787

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.